119 articles - From Friday Apr 14 2023 to Friday Apr 21 2023
Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…
| Clin Gastroenterol Hepatol |
AGA Clinical Practice Update on the Diagnosis and Management of Extraesophageal Gastroesophageal Reflux Disease: Expert Review. BEST PRACTICE ADVICE 10: Shared decision-making should be performed before referral for anti-reflux surgery for EER when the patient has clear, objectively defined evidence of GERD. However, a lack of response to PPI therapy predicts lack of response to anti-reflux surgery and should be incorporated into the decision process. |
| Endoscopy |
Gastrointestinal endoscopy devices and the European Union Medical Device Regulation: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Private European companies called "notified bodies" are entitled to conduct device approval for the EU. The ESGE will actively engage with these notified bodies for topics related to the new endoscopy device approval process to ensure continued access to high quality endoscopy devices for endoscopists in Europe. |
| Gut |
Consensus definition of sludge and microlithiasis as a possible cause of pancreatitis. We propose a consensus definition for the localisation, ultrasound morphology and diameter of biliary sludge and microlithiasis as distinct entities. Interestingly, severity of biliary AP was not dependent on the size of concrements warranting prospective randomised studies which treatment options are adequate to prevent recurrence. |
meta-analyses and systematic reviews
| Clin Gastroenterol Hepatol |
Endoscopy unit level interventions to improve adenoma detection rate - a systematic review and meta-analysis. The provision of report cards and the presence of an additional observer to identify polyps are associated with improved ADR and should be considered for implementation in endoscopy facilities. |
HLA-DQA1*05 Genotype and Immunogenicity to Tumor Necrosis Factor-a Antagonists: A Systematic Review and Meta-analysis. Variants in HLA-DQA1*05 are associated with an increased risk in immunogenicity and secondary loss of response in patients with IMIDs treated with TNFa antagonists. However, the positive and negative predictive value is moderate, and decisions on concomitant use of IMMs to prevent immunogenicity should be individualized based on al factors that influence drug clearance. |
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
A translational pharmacokinetic/pharmacodynamic approach supports optimal vonoprazan dosing for erosive oesophagitis and Helicobacter pylori infection. Vonoprazan 20 mg once- and twice-daily dosing demonstrated high, dose-dependent, 24-hour intragastric acid control in this PK/PD model, supporting clinical efficacy data in patients with acid-related disorders. |
Buspirone for early satiety and symptoms of gastroparesis: A multi-centre, randomised, placebo-controlled, double-masked trial (BESST). Patients with moderate-to-severe early satiety/postprandial fullness and other symptoms of gastroparesis did not benefit from buspirone treatment to improve the ES/PPF primary outcome compared with placebo. There was a suggestion of the benefit of buspirone in patients with more severe bloating. |
Evaluation of a downstaging, bidirectional version of the Montreal classification of Crohn's disease: Analysis of 5-year follow-up data from the prospective BioCrohn study. An additional bidirectional disease behaviour assessment capturing reversed or fully controlled complications may provide a more realistic appraisal of the complexity and unmet needs of patients treated with advanced therapies. |
Non-invasive diagnosis of alcohol-related steatohepatitis in patients ongoing alcohol withdrawal based on cytokeratin 18 and transient elastography. We propose a new validated non-invasive score for the diagnosis of ASH in patients ongoing alcohol withdrawal. This score can help to identify patients that may benefit from potential therapeutics or motivate them to reduce alcohol consumption. |
Patients with elderly onset inflammatory bowel disease have a decreased chance of initiation of all types of medications and increased risk of surgeries-A nationwide cohort study. We found significantly low chance of initiation of IBD medications in elderly patients, the reason may not be due to mild disease course. In elderly patients, drug persistency was comparable to adults. Clinicians should carefully consider whether they underuse IBD-specific medications in elderly patients, and special attention should be applied to timely discontinuation of corticosteroids. |
Physiologically based pharmacokinetic modelling to predict intragastric rifabutin concentrations in the treatment of Helicobacter pylori infection. PBPK modelling showed rifabutin 50 mg three times daily had higher intragastric exposure times than 150 mg once daily or twice daily, or 300 mg once daily. This low-dose rifabutin regimen provides the highest potential for H. pylori eradication while minimising systemic rifabutin exposure. |
Population-attributable risk of modifiable lifestyle factors to hepatocellular carcinoma: The multi-ethnic cohort. Modifying lifestyle factors, particularly coffee intake, may have a substantial impact on HCC burden in diverse populations, with greater impact among lean adults. Diet and lifestyle counselling should be incorporated into HCC prevention strategies. |
| Am J Gastroenterol |
Association of Anxiety and Gastrointestinal Comorbidities in Repeat Hospital Admissions in Pediatric Cyclic Vomiting Syndrome. 90-day admission rates in pediatric CVS are decreasing overall, although still contributing to significant healthcare expenditure. Anxiety and gastrointestinal comorbidities were associated with increased risk of repeat admissions. Further prospective studies are needed to better understand the complex interactions of these comorbidities and, their management affecting the natural course of CVS. |
Risk of Incident and Fatal Colorectal Cancer after young-onset adenoma diagnosis: a national cohort study. Young-onset advanced adenoma diagnosis was associated with 8-fold increased incident CRC risk compared to normal colonoscopy. However, cumulative CRC incidence and mortality at ten years were relatively low. |
Utilization of Treat-to-Target Monitoring Colonoscopy after Treatment Initiation in the US-Based Study of a Prospective Adult Research Cohort with Inflammatory Bowel Disease (SPARC IBD). About half of SPARC IBD patients received colonoscopy in the 3-15 months following initiation to new IBD treatment, suggesting low uptake of treat-to-target colonoscopy for assessment of mucosal healing in real-world clinical practice. The variation in colonoscopy use between study sites suggests a lack of consensus and a need for more robust evidence associating the practice of routine monitoring colonoscopy with improved patient outcomes. |
What is unspecified functional bowel disorder? A commonly seen, rarely recognized, and poorly understood diagnosis. FBD-U, by Rome IV criteria, is highly prevalent in clinical settings. These patients are not represented in mechanistic studies or clinical trials for not having met Rome IV criteria for other FBDs. Making future Rome criteria less stringent would minimize the number fulfilling criteria for FBD-U and maximize the true representation of FBDs in clinical trials. |
| Clin Gastroenterol Hepatol |
A newly proposed severity index for eosinophilic esophagitis is associated with baseline clinical features and successful treatment response. The newly developed I-SEE correlates with many clinical features at diagnosis, and severity improves with successful tCS treatment. Additional investigations in other populations can further confirm its utility. |
Cenicriviroc Lacked Efficacy to Treat Liver Fibrosis in Nonalcoholic Steatohepatitis: AURORA Phase III Randomized Study. This study did not demonstrate the efficacy of CVC for treating liver fibrosis assessed by histology in adults with NASH; however, CVC was safe and well tolerated in patients with NASH and liver fibrosis (ClinicalTrials.gov number, NCT03028740). |
| Endosc Int Open |
Degree of pharyngeal deformation caused by pharyngeal endoscopic submucosal dissection is associated with the incidence of aspiration pneumonia. The incidence of aspiration pneumonia in the long-term course after pharyngeal ESD was revealed. The incidence of aspiration pneumonia may be associated with pharyngeal deformity, but further studies are needed. |
| Endoscopy |
Artificial intelligence based polyp size measurement in gastrointestinal endoscopy using the auxiliary water jet as a reference. In this work, we present a novel AI-based method for measuring colorectal polyp size with significantly higher accuracy than other common sizing methods. |
| Gastroenterology |
Combination of mucosa-exposure device and computer-aided detection for Adenoma Detection during Colonoscopy: a randomized trial. The combination of CADe and EndocuffVision during colonoscopy increases ADR and adenomas detected per colonoscopy without increasing withdrawal time compared to CADe alone. no NCT04676308. |
Distinct serum immune profiles define the spectrum of acute and chronic pancreatitis from the multi-center PROCEED study. Immune profiling of serum samples from a large pancreatitis cohort led to identifying distinct immune markers that could serve as potential biomarkers to differentiate the varying pancreatitis disease states. In addition, the finding of IL-17 signaling in CP could provide insight into the immune mechanisms underlying disease progression. |
Gallstones, cholecystectomy and kidney cancer: observational and Mendelian randomisation results based on large cohorts. Both observational and causal MR estimates based on large prospective cohorts support an increased risk of kidney cancer in gallstone patients. Our findings provide solid evidence for the compelling need to diagnostically rule out kidney cancer before and during gallbladder removal, to prioritise kidney cancer screening in patients undergoing cholecystectomy in their 30s, and to investigate the underlying mechanisms linking gallstones and kidney cancer in future studies. |
Long-term exposure to fine particulate matter and incidence of esophageal cancer: a prospective study of 0.5 million Chinese adults. Background & aims Evidence is sparse and inconclusive on the association between long-term PM was associated with an elevated risk of esophageal cancer. With stringent air pollution mitigation measures in China, a large reduction in the esophageal cancer disease burden can be expected. |
| Gastrointest Endosc |
A Novel Suturing Device Enables Safe and Effective Closure of Large Defects After Endoscopic Submucosal Dissection. OverStitch SX enabled safe and effective closure of large defects post ESD. Future trials are needed to determine its superiority over OverStitch TM for the closure of defects in challenging locations. |
Comparison of long-term outcomes of endoscopic ultrasound-guided gallbladder drainage and endoscopic transpapillary gallbladder drainage for calculous cholecystitis in poor surgical candidates: A multicenter propensity score-matched analysis. Long-term stent placement via EUS-GBD is a promising potential option for limiting late AEs, including recurrence, in poor surgical candidates with calculous cholecystitis. |
Factors associated with increased duration of endoscopic submucosal dissection for rectal tumors: A 22-year retrospective analysis. The results of the present study suggest that the location of a lesion involving the dentate line, resection size =50 mm, circumferential range =2/3, and invasion depth =T1b are the independent risk factors for prolonged ESD procedure time. |
Risk factors for endoscopic ultrasound-guided radiofrequency ablation adverse events in patients with pancreatic neoplasms: a large national French study (RAFPAN study). The results of this large study confirm an overall acceptable safety for pancreatic EUS-RFA. Tight proximity (= 1mm) to the MPD represents an independent risk factor for AE. Good clinical outcomes in terms of tumor ablation were observed, especially in the case of small NENs. |
Self-propelling thrombin powder enables hemostasis with no observable rebleeding or thrombosis over three days in a porcine model of upper gastrointestinal bleeding. SPTP is a promising novel material that stopped diffuse ulcer bleeds in 5 pigs without rebleeding or adverse local or systemic events. |
| Gut |
Genetic coding variant in complement factor B (CFB) is associated with increased risk for perianal Crohn's disease and leads to impaired CFB cleavage and phagocytosis. Objective Perianal Crohn's disease (pCD) occurs in up to 40% of patients with CD and is associated with poor quality of life, limited treatment responses and poorly understood aetiology. We performed a genetic association study comparing CD subjects with and without perianal disease and subsequently performed functional follow-up studies for a pCD associated SNP in is a loss-of-function mutation that impairs its cleavage, activation of alternative complement pathway, and pathogen phagocytosis thus implicating the alternative complement pathway and CFB in pCD aetiology. |
Impact of delayed screening invitations on screen-detected and interval cancers in the Dutch colorectal cancer screening programme: individual-level data analysis. The impact of the first COVID-19 wave on screening yield was modest. A very small proportion of the FIT negatives had an interval CRC possibly due to an extended interval, which potentially could have been prevented if they had received the invitation earlier. Nonetheless, no increase in interval CRC rate was observed, indicating that an extended invitation interval up to 30 months had no negative impact on the performance of the CRC screening programme and a modest extension of the invitation interval seems an appropriate intervention. |
Long versus short peroral endoscopic myotomy for the treatment of achalasia: results of a non-inferiority randomised controlled trial. Our study demonstrates non-inferiority of a shorter cut length of POEM as compared with the standard treatment, which saved some procedural time. GORD rate was not reduced by reducing cutting length. |
| Hepatology |
Epigenetic memory of environmental exposures as a mediator of liver disease. What remains unclear, however, is what drives the transition from a beneficial epigenetic memory to a maladaptive scar, the epigenetic processes involved in forming these memories, and whether this process can be modulated for therapeutic purposes. In this review, we discuss these concepts in relation to liver disease and more broadly using examples from other tissue types and diseases, and finally consider how epigenetic therapies could be employed to reprogram maladaptive epigenetic memories to delay and/or prevent hepatocarcinogenesis. |
Intermittent fasting- the future treatment in nash patients? Basic science and clinical studies have shown that apart from inducing body weight loss, improving cardio-metabolic parameters, namely blood pressure, cholesterol and triglyceride levels, insulin and glucose metabolism, IF can reduce inflammatory markers, endoplasmic reticulum (ER) stress, oxidative stress, autophagy, and endothelial dysfunction, as well as modulate gut microbiota. This review aims to further explore the main NASH pathogenetic metabolic drivers on which IF can act upon and improve the prognosis of the disease, and summarize the current clinical evidence. |
Lactulose therapy for patients with cirrhosis, portal hypertension, and poor patient reported outcomes - the Mi-Kristal RCT. Lactulose improves sleep and activity impairment in patients with poor PROs. We did not observe improved global HRQOL after 28-days using the SF-8 instrument. |
Plasticity between ILC2 subsets and amphiregulin expression regulate epithelial repair in biliary atresia. These findings identify a key function of the IL-13/IL-4Ra/STAT6 pathway in ILC2 plasticity and an alternate circuit driven by IL-2 to promote nILC2 stability and amphiregulin expression. This pathway induces epithelial homeostasis and repair in experimental biliary atresia. |
Semaphorin 3C exacerbates liver fibrosis. Finally, deletion of either SEMA3C or NRP2, specifically in activated HSCs, reduces liver fibrosis in mice. SEMA3C is a novel marker for activated HSCs that plays a fundamental role in the acquisition of the myofibroblastic phenotype and liver fibrosis. |
The role of the gut microbiome in the development of hepatobiliary cancers. Finally, we highlight some emerging gut microbiome editing techniques currently being investigated in the context of hepatobiliary diseases. Although much work remains to be done in determining the relationships between the gut microbiome and hepatobiliary diseases, emerging mechanistic insights are informing novel treatments such as potential microbiota manipulation strategies and guiding public health advice on dietary/lifestyle patterns for the prevention of these lethal cancers. |
Use of HBV RNA and hepatitis B core-related antigen to predict change in serological status and disease activity in CHB. Given the high predictive ability of readily available markers, HBcrAg and HBV RNA have a limited role in improving prediction of key serologic and clinical events in patients with CHB. |
| J Hepatol |
A multicenter randomized-controlled trial of nucleos(t)ide analogue cessation in HBeAg-negative chronic hepatitis B. Cessation of NUC treatment was associated with a significantly higher rate of HBsAg loss than continued NUC treatment, which was largely restricted to patients with end of treatment HBsAg levels <1,000 IU/ml. Impact and implications As HBeAg-negative patients with chronic hepatitis B on nucleos(t)ide analogues (NUCs) rarely achieve functional cure, treatment is almost always lifelong. The STOP-NUC trial was conducted to investigate whether discontinuing long-term NUC treatment can increase the cure rate. We found that some patients achieved functional cure after stopping NUCs, which was especially pronounced in patients with HBsAg levels <1,000 at the end of NUC treatment, and that many did not need to resume therapy. The results of the Stop-NUC trial provide evidence for the concept of stopping NUC treatment as a therapeutic option that can induce functional cure. |
Clearance and production of ammonia quantified in humans by constant ammonia infusion - the effects of cirrhosis and ammonia targeting treatments. Whole-body ammonia clearance and production may be measured separately by the technique used. The method identified a lower clearance and a higher production in patients with cirrhosis, and showed that phenylbutyrate increases clearance, whereas lactulose + rifaximin reduces production. The method may be used to examine a range of questions related to normo-/pathophysiology and ammonia-targeting treatment mechanisms. Impact and implications High blood ammonia plays a key role in liver cirrhosis related brain dysfunction. However, the relative roles of increased ammonia production and reduced ammonia clearance are poorly understood as is the action of ammonia-targeting treatments. This study presents a relatively simple test to measure ammonia metabolism. By use of this test, it was possible to show that patients with liver cirrhosis have decreased ammonia clearance and increased ammonia production compared with healthy persons and to quantify distinctively different ammonia-targeting treatment effects. The test presented holds several perspectives for future studies of normal physiology and pathophysiology, not least in regard to elucidating effects of ammonia-targeting therapies. Clinical trial number ClinicalTrials.gov (1-16-02-297-20). |
HILPDA promotes NASH-driven HCC development by restraining intracellular fatty acid flux in hypoxia. Hepatic HILPDA is a pivotal oncometabolic factor in the NASH liver microenvironment and represents a novel potential therapeutic target. Impact and implications Nonalcoholic steatohepatitis (NASH, chronic metabolic liver disease caused by buildup of fat, inflammation and damage in the liver) is emerging as the leading risk factor and the fastest growing cause of hepatocellular carcinoma (HCC), the most common form of liver cancer. While curative therapeutic options exist for HCC, it frequently presents at a late stage when such options are no longer effective and only systemic therapies are available. However, systemic therapies are still associated with poor efficacy and some side effects. In addition, no approved drugs are available for NASH. Therefore, understaing the underlying metabolic alterations occurring during NASH-HCC is key to identify new cancer treatments that target the unique metabolic needs of cancer cells. |
| Neurogastroenterol Motil |
ACE and ACE2 catalytic activity in the fecal content along the gut. This work is the first to report the presence of catalytically active ACE and ACE2 in the rat intestinal content, supporting future research on the regulatory role of the intestinal RAAS on gut function and a putative link to the microbiome. |
Defecatory disorders in patients with type 1 diabetes and chronic constipation. Among T1DCC patients, 37 (32%) had prolonged BET, which was associated with anorectal pressures indicative of a DD but was not associated with reduced rectal sensation, suggesting that DDs are more likely explained by abdomino-anal dyscoordination than visceral disturbance. |
Randomized controlled pilot study assessing fructose tolerance during fructose reintroduction in non-constipated irritable bowel syndrome patients successfully treated with a low FODMAP diet. Non-constipated, LFD-responsive IBS patients should be reintroduced to fructose in higher doses than 15 g to assess tolerance. LFD is associated with significant changes in microbial composition and bacterial genes involved in FODMAP metabolism. |
The epidemiology and psychological comorbidity of disorders of gut-brain interaction in Australia: Results from the Rome Foundation Global Epidemiology Study. The current study represents the most comprehensive epidemiological exploration of DGBI and mental health in Australia to date, including their prevalence and distributions across sex and age, associations between DGBI and anxiety, depression, and somatization. The findings warrants future comparisons between population characteristics and health care systems differences in order to reduce the burden of DGBI and mental illness worldwide. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Aliment Pharmacol Ther |
Review article: Putting some muscle into sarcopenia-the pathogenesis, assessment and clinical impact of muscle loss in patients with inflammatory bowel disease. Sarcopenia is associated with poor clinical outcomes independent of IBD activity and therefore muscle health should be assessed in al IBD patients at routine intervals. Future studies to better our understanding of the pathophysiology as well as most effective management of sarcopenia in IBD will help guide clinical care and reduce disease related complications. |
| Clin Gastroenterol Hepatol |
Actionable Solutions to Achieve Health Equity in Chronic Liver Disease. We must forge and/or strengthen collaborations between patients, community members, other key stakeholders, healthcare providers, healthcare institutions, professional societies, and legislative bodies. Herein, we provide a high-level review of current disparities in chronic liver disease and describe actionable strategies which have potential to bridge gaps, improve quality and promote equity in liver care. |
New perspectives on development of curative strategies for chronic hepatitis B. Nucleos(t)ide analogues will likely remain an essential backbone of future combinations to control viral replication and prevent resistance to antiviral drugs. In this review, we discuss perspectives on approaches to achieving functional cure, with a review of virological and immunological strategies, highlighting challenges and unresolved questions with the various attempts to achieve cure, as well as exploring alternative endpoints such as partial cure and new non-invasive viral and immunological biomarkers to stratify patients and predict/monitor antiviral response. |
Non-invasive assessment of liver fibrosis in NAFLD. This review provides a roadmap for future development and integration of NITs in clinical practice and in drug development in NAFLD. We discuss herein the principles for their development and validation, their use in clinical practice, including for diagnosis of NAFLD, risk stratification in primary care and hepatology settings, prediction of long-term liver and non-liver-related outcomes, monitoring of fibrosis progression and regression, and response to future treatment. |
| Endosc Int Open |
| Gastroenterology |
Defining interactions between the genome, epigenome, and the environment in inflammatory bowel disease: progress and prospects. We discuss a model in which environmental factors imprint disease risk in a window of susceptibility during infancy that may contribute to later disease onset; whilst other elements of the exposome act later in life and contribute directly to the pathogenesis and course of the disease. Understanding the mechanisms underlying GxE interactions may provide the basis for new therapeutic targets or preventative strategies for IBD. |
| J Hepatol |
An integrated view of anti-inflammatory and antifibrotic targets for the treatment of NASH. g., CAR T) may accelerate repair through HSC deactivation or killing, or by enhancing matrix degradation. Heterogeneity of disease - either due to genetics or divergent disease drivers - is an obstacle to defining effective drugs for al patients with NASH that will be incrementally overcome. |
| Neurogastroenterol Motil |
Impact of opioids on esophageal motility. This review article will discuss our current understanding of OIED and provide context for this latest study in chronic opioid users. Further investigation with larger prospective studies is needed to understand the pathophysiology, diagnosis, and management of OIED. |
misc publications eg case reports, tools of the trade, images of the month, etc…
| Am J Gastroenterol |
| Clin Gastroenterol Hepatol |
| Endosc Int Open |
| Endoscopy |
| Gastroenterology |
| Gastrointest Endosc |
| Hepatology |
| J Hepatol |
Letters to the editors and authors’ replies
| Aliment Pharmacol Ther |
| Clin Gastroenterol Hepatol |
| Gastroenterology |
| Gastrointest Endosc |